title: Differentiating a large abdominal cystic lymphangioma from multicystic mesothelioma: report of a case.
abstract: We report a case of retroperitoneal cystic lymphangioma in a 30-year-old woman who presented with abdominal distention and pain. Imaging studies revealed a large, thin-walled multicystic mass occupying the whole abdomen. Based on a preoperative diagnosis of multicystic mesothelioma, we performed laparotomy, which revealed a tumor arising from the gastropancreatic ligament in the posterior wall of the omental bursa. We resected the tumor completely, without the adjacent viscera. The final pathological diagnosis was cystic lymphangioma, based on the immunohistochemical findings of positive CD31 and CD34 expression, the presence of smooth muscle confirmed by smooth muscle antigen and desmin, and negative calretinin, WT-1 and cytokeratins 5/6 expression. Multicystic mesotheliomas and cystic lymphangiomas are so similar in morphology that immunohistochemical staining should be fully utilized to differentiate them.
authors.affiliation: Department of Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, 296-8602, Japan, hiroshin84@gmail.com.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nagata
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yonemura
authors.forename: Emel
authors.initials: E
authors.lastname: Canbay
authors.forename: Haruaki
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Narita
authors.forename: Makio
authors.initials: M
authors.lastname: Mike
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Kano
mesh_terms: D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D003893:Desmin / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007813:Laparotomy; D018191:Lymphangioma, Cystic / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008654:Mesothelioma; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D003893:Desmin; D019408:Platelet Endothelial Cell Adhesion Molecule-1